Teaching Hospitals May Be Only Option

February 21, 1989|By ELIZABETH ROBERTS, Special to the News By ELIZABETH ROBERTS, Special to the Sun-Sentinel

Everyone has heard the stories. There`s the one about the woman who died of breast cancer after futilely seeking treatment for two years at an area teaching hospital for a lump in her breast. There is the story about the hospital mistakenly releasing to a couple the body of an infant boy, instead of that of their infant daughter, who died nine days after birth.

If the stories are familiar, the complaints about teaching hospitals are almost cliche.

Administrators at teaching hospitals in Miami and Gainesville acknowledge they may not be for everyone. But they can be the only option for people with unusual or extreme illnesses.

When it comes to organ transplants, for example, the alternative to a teaching hospital is stark. Steven Sloate, vice president of planning and marketing for Shands Hospital at the University of Florida, flatly says: ``If you cannot access such a center and receive an organ, you will die.``

Every patient, regardless of ailment, must weigh the benefits vs. the drawbacks, says Dr. Gerard Kaiser, senior vice president for medical affairs at Jackson Memorial Hospital in Miami, also a teaching hospital. ``Some people find that going to a teaching hospital where medical students and house officers participate in care is not something they wish to have,`` he says. ``Some describe it as having their privacy invaded, and I think it is a valid concern for some patients.``

But ``patients have access to the latest scientific developments and the newest technology,`` he says, ``and because the doctors are on the cutting edge of their specialties, patients are assured of quality care.``

Sloate points out that teaching hospitals are the only institutions that provide round-the-clock access to multidisciplinary teams of medical professionals. ``You can be sure that someone is here with the skill to take care of your needs,`` he says. And in some cases, academic medical centers provide treatments unavailable anywhere else. The reason? It is the mission of a teaching hospital to bring treatments from the laboratory to the marketplace.

``Because of the way new technology moves into the industry, only academic medical centers working through the Food and Drug Administration have access to these latest developments,`` Sloate says.

Teaching hospitals provide one further advantage. Since they often are the institutions of last resort for the severely ill, doctors grow accustomed to seeing and treating unusual cases.

As for the concern that teaching hospitals allow students to perform unnecessary procedures in order to learn, Kaiser says that government restrictions on Medicare payments for given procedures make it economically unfeasible.

``I would submit to you that under the current method of reimbursement, where Medicare pays for product not process, the same pressures are on teaching hospitals as are on private hospitals,`` he says. ``Hospitals must provide quality care that is cost-effective, and it does not pay the hospital or the doctor to provide unnecessary procedures of any sort.``